One of the greatest mediators of risks to an infant with a myelomeningocele is:

Choice A rationale

Surgical intervention is not the initial step for uterine atony as conservative measures, such as fundal massage, are prioritized to encourage uterine contraction and reduce bleeding.

Choice B rationale

Fundal massage stimulates uterine contraction by mechanically compressing the myometrium, which helps to constrict the spiral arteries and reduce hemorrhage caused by uterine atony.

Choice C rationale

Establishing venous access is critical for fluid resuscitation but does not directly address the underlying cause of hemorrhage, which requires mechanical or pharmacological uterine contraction.

Choice D rationale

Catheterizing the bladder can prevent displacement of the uterus but does not directly address uterine atony. An empty bladder supports fundal massage by allowing proper uterine positioning.

Choice A rationale

Placing the infant prone increases the risk of sudden infant death syndrome (SIDS), particularly for neonates. Supine positioning reduces this risk and is supported by evidence-based guidelines for infant care.

Choice B rationale

Tightly swaddling and dimming lights mimic the in utero environment, reducing overstimulation and promoting self-regulation. This is especially vital for neonates with neonatal abstinence syndrome (NAS), who are sensitive to external stimuli.

Choice C rationale

Providing excessive stimulation can exacerbate stress responses in neonates with NAS. This may manifest as increased crying, irritability, and tachycardia, worsening their fragile physiological state.

Choice D rationale

Feeding half-strength formula is not advised as it may cause inadequate caloric intake and impaired weight gain. Normal feeding practices, with proper intervals, are crucial to supporting healthy growth and development.